Pioneer wants to eradicate caries by 2020
by Patti DiGangi, RDH, BSMartin Luther King had a dream. Walt Disney had a dream. Henry Ford had a dream. G.V. Black, father of
Dr. V. Kim Kutsch
This dream resonates with the FDI World Dental Federation Global Caries Initiative: "Global Caries Initiative is a profession-led call to action to eradicate caries, and thus, improve the oral and general health of populations globally by the year 2020."2
The year 2020 is less than 10 years away. You may already be thinking that it can't happen. That is the difference between Dr. Kutsch and the majority of dental practitioners. He can see the dream. He believes the dream. He is actively working every day to make that dream happen.
This first takes a clarification of terms. Dentistry has long used the terms cavities and caries interchangeably. The terms are not the same. Caries is the process and cavities are the outcome. Caries have been thought to have been caused by one to two specific pathogens. This is not correct.
Caries is a complex, multipathogenic biofilm disease. Yet it is not a pathogen specific disease. What about the sugar part of the equation? A 2003 study showed the selection pressure for the biofilm that produces dental caries is not sugar availability but rather prolonged periods of low pH.3 Additional 2009 studies demonstrated the microbial shift was directly proportional to the pH shift.4,5 Simply put, dental caries is a biofilm mediated, pH specific disease. Or that is the current understanding. Ongoing research continues to expand our knowledge of the caries process.
The cariology philosophy being taught in many dental and dental hygiene schools is called CAMBRA, or Caries Management by Risk Assessment. CAMBRA represents a giant leap forward for the dental profession. Treating caries successfully can be simple. CAMBRA utilizes all available diagnostic data to assess the patient's risks for this disease, including oral exam, radiographs, a risk assessment form, biometrics, and history with the patient. It is not just looking for cavities.
Dr. Kutsch is founder, fellow, diplomat, and the first president of the World Congress of Minimally Invasive Dentistry (WCMID, www.wcmid.org.) Minimally invasive dentistry (MID) is based on a medical model that controls the disease first and then uses minimally invasive techniques to restore the mouth to form, function, and esthetics. In practical terms, that means to diagnose caries and treat the infection before it causes damage. It is concerned with the first-occurrence, earliest detection, and earliest possible treatment on micro-molecular levels. MID aims to empower patients through information, skills, and motivation to be in charge of their own oral health so that they require only minimum intervention of the dental profession.
Dr. Kutsch works in his private practice in Albany, Ore., and has owned a number of dental companies. Dr. Kutsch serves as CEO and chief technical officer for Oral BioTech, manufacturers of the CariFree System (www.carifree.com). The CariFree system is a simple protocol for assessing your patients' risk factors for decay along with a real-time, chairside technology for diagnosing the caries infection. There are a variety of products in treatment kits for both adults and children that contain fluoride, xylitol, proprietary neutralizing pH+ technology, and more.
Yet it isn't about jumping to products; risk assessment and diagnosis are equally important to know which products fit each person. There is no one-size-fits-all. Dr. Kutsch's efforts are based on the best principles of evidence-based medicine which is the integration of best research evidence with clinical expertise and patient values.6
America has produced many talented people who dreamed a dream and achieved extraordinary accomplishments and made a difference to society. Dr. Kutsch is an inventor and holds numerous patents, yet he isn't ready to rest on his laurels. Dr. Kutsch continues to dream and is a true pioneer in dentistry and someone you should know.
Patti DiGangi, RDH, BS, is a vision-driven person finding strength and direction from her inner convictions. Like most true visionaries, she views obstacles as learning experiences that can be used for self-development. As a lifelong learner, her energetic, thought-provoking, and successful program development and mind-bending view of what can be shine a bright light for others to preview the future and find their place in it. She can be contacted through her Web site at www.pdigangi.com.
- Herring H. "Open Wide: Pioneer Dentist Gets His Due." April 15, 2008. New York Times.
- Global Caries Initiative. 2009. FDI World Dental Federation. Available at: http://www.fdiworldental.org/content/global-caries-initiative.
- Fejerskov O, Kidd E. Dental Caries: The disease and its clinical management. Blackwell Munksgaard 2003 Oxford UK. Pp:4-5. Available at: http://jdr.sagepub.com/content/83/suppl_1/C35.full.
- Young DA, Kutsch VK, Whitehouse J. A clinician's guide to CAMBRA: a simple approach. Compend Contin Educ Dent March 2009; 30(2):92-8. Available at: http://www.compendiumlive.com/article.php?id=2551.
- Twetman S, Fontana M. Patient caries risk assessment. Monograph. Oral Sci 2009; 21:91-101.
- Sackett D, Straus S, Richardson W. Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed. London, England: Churchill Livingstone, 2000.